• Courtesy David R. Jordan, MD
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    Oculoplastics/Orbit

    Examples of complications after enucleation and evisceration surgery. A, Implant exposure of a porous orbital implant (hydroxyapatite) occurring 2 years after enucleation. Implant exposure can also occur in a similar fashion after evisceration. Treatment involves placing a patch graft (eg, temporalis fascia, donor sclera) over the exposed area. B, A subconjunctival cyst is seen 5 years after enucleation and is affecting the proper fit of the prosthetic eye. Surgical excision is required to remove the cyst. The same thing can occur after evisceration surgery. C, Implant exposure around the implant occurring 3 years after enucleation and peg placement. The peg shaft and implant are visible. A patch graft is required to cover the implant and peg shaft (eg, temporalis fascia, donor sclera). The same problem can occur after evisceration. D, A patient post evisceration presents with socket tenderness and recurrent discharge despite a course of topical and oral antibiotics. An infected orbital implant is suspected and implant removal is suggested. E, During implant removal surgery, as the tissues were incised over the implant, purulent discharge was visualized. The purulent discharge was cultured and grew Streptococcus pyogenes. Implant infection after enucleation occurs in a similar fashion.